Monday, September 7, 2015

Ancient Auditory Acoustic Abominations

Despite posters at every nursing station of this nurse encouraging silence, old hospitals were loud places. There were even signs posted on the street advising QUIET HOSPITAL ZONE. The smooth terrazzo floors, tiled walls, and plaster ceilings amplified and projected noise everywhere. Some of the noises were not really an abomination and I actually miss them, but sometimes I get carried away with alliteration in the titles. Blame it on my advanced age.

The most prominent and persistent noise in hospitals was the ever present squacking of the public address loudspeaker system paging doctors. I am not really fond of cell phones and do not even own a smart phone, but the elimination of constant verbal paging in hospitals justifies their existence.  The most common pages were for things like "Dr, Slipdidgit call 302...Dr. Slipdigit call 302" Every now and then you would hear alarming ones like "Any general surgeon to the OR" and you just knew bad things were happening. Really bad things had number codes a "33" was a cardiac arrest, a "55" was a fire and a "77" was for an assaultive patient, usually in the ER. The following page was actually made at our hospital: "This is a test of the public address system. If you cannot hear this page, please call the operator immediately."

Some of our older rooms did not have call lights. The nurse was summoned by the patient ringing an actual bell. Some of our older instructors thought call bells and call lights were not necessary. According to their thinking the nurse should be close by and aware of her patients' needs. On the wards of 8 patients, the nurse was always in the same room with them. Lights flashing or bells ringing were a sign of poor nursing care because the nurse was not anticipating needs.

Dropping anything made of metal or glass on terrazzo floors made a very loud CRASH. There is nothing like being aroused from your sleep deprived stupor at 4AM by the crash , splash, and swearing that goes along with a full metal bedpan dropping on a terrazzo floor in the middle of the night. Dropping glass IV or suction bottles also makes an impressive noise. A common scenario would involve  setting a round, glass IV bottle on a flat surface to make a time strip, getting distracted and letting that glass bomb roll. The crash would disperse glass shards to all corners of the room and if it was D5W you had the added element of stickiness to contend with. Yes, I have personal experience with that kind of embarrassing mess. The breaking glass always brought a large crowd of onlookers that seldom offered to participate in the cleanup.

Portable suction machines (no wall suction) made a loud buzzing noise that always reminded me of  those new-fangled electric alarm clocks. Combine that with the coughing, hacking, and gurgling noise of viscous green mucous dancing in the suction tube and you had a very distinctive sound. Sort off  like a Maytag on the rinse cycle in the midst of a TB sanatorium full of patients coughing and hacking.

Here is one hospital noise experience I really miss. We sent out our linen via chutes that were similar to large sewer pipes that ran vertically throughout the hospital. For real fun head up to the 6th floor or higher and fill up a linen bag so the diameter of the bag matches the caliber of the chute. Drop that bag down the chute and you will hear a noise that resembles a 747 on takeoff roll. All that air being sucked down the chute even resembles the jet wash from the plane taking off. WHOOSH -  Really impressive.

In the lab, CBCs were done manually with a technician physically counting the different types of cells. They used little clicker devices to keep track of the count. The lab sounded like a newspaper press room with all the typewriters blazing away..oops, today  we don't have those either.

Our elevators had a big gap between the car and the floor. Dietary carts were loaded with actual ceramic plates and cups. When one of these carts got stuck in the gap, a terrible thud and crash noise would occur sounding like every plate and cup on the cart broke.

When working as a scrub nurse I used to love that splat noise a diseased gall bladder made when the surgeon tossed it in the kick bucket. It was a conditioned response denoting that all that remained was closing up. We were almost done. The circulating nurse always recorded the anesthesia start and surgical start time, but many of the surgeons were really interested in their "bucket time" and frequently asked the nurses to back them up when they bragged, "I got a gall bladder in the bucket in 12  minutes."

Metal chart racks filled with metal clipboard paper charts were rolling noise makers. Patients always knew when the MDs were rounding because of the crashing and banging of metal against metal. Every time a chart was retrieved or returned it sounded like a mini car wreck. Just what a patient needs to hear lying in bed recovering from an invasive open surgery.

We had autoclaves in central supply and a couple of smaller ones in the OR used mainly for "flashing" instruments that were needed at the last minute. The OR autoclaves vented their steam outside on the exhaust cycle. The noise made by all that steam being vented sounded like an old time locomotive. Even more impressive was that huge white contrail-like cloud of steam visible out the window. For thanksgiving, I am going to provide my hospital tested procedure for cooking a turkey in an autoclave. Yes, we really did that when on call, but it was anesthesia's idea.

If you liked this post, you might be interested in "This Place Smells Funny," a previous post about olfactory abominations.

A special thanks to everyone toiling in a hospital on this Labor Day and I hope you are being justly compensated for your sacrifices.